Table 4.

How Claims-Based Comprehensiveness Measures would Differ for Different Clinician Types

	Range of conditions treateda	New problems managedb	Involvement in patient conditionsc	Scope of services providedd
Truly comprehensive clinician providing primary care to young adults: well, preventive, acute, chronic and multimorbid care including range of procedures	Clinician would be labeled as comprehensive, assuming his/her panel is not limited to a unique population with just a few needs	Would not be able to detect this, but that is not the goal of this measure	Clinician would be labeled as comprehensive, assuming his/her panel is not limited to a unique population with just a few needs	Would not discriminate well except for procedures and site of care
Truly comprehensive clinician providing primary care for geriatric population: well, preventive, acute, chronic and multimorbid care including range of procedures	Clinician would be labeled as comprehensive, assuming his/her panel is not limited to a unique population with just a few needs	Would not be able to detect this, but that is not the goal of this measure	Clinician would be labeled as comprehensive, assuming his/her panel is not limited to a unique population with just a few needs	Could be useful to capture those doing home visits, inpatient care for frail elderly population
Clinician who focuses mostly on providing relevant services for the conditions within the purview of his/her specialty (e.g., general internist vs. cardiologist)	Would appear less comprehensive, which is appropriate	How comprehensive the physician appears would depend on whether conditions were limited to those most commonly seen in primary care	Would appear to be less comprehensive, which is appropriate	Clinician would look more comprehensive
Clinician working in an urgent care clinic	Could appear more comprehensive than actually is	Measure not appropriate for this setting	Would appear not to be comprehensive, which is appropriate	Depends on range of procedures offered in the urgent care clinic
Clinician who tends to “Document and Refer” (i.e., lists, but does not treat, most of the ICD codes s/he lists on claims)	Would appear more comprehensive than s/he actually is	Would be able to distinguish between more vs. less comprehensive clinician	Would appear to be more comprehensive than s/he truly is	Would not discriminate well except for procedures and site of care

^aRange of conditions treated method assesses the range of ICD codes listed on claims by physician for a given time period, e.g., 1 year.

^bNew problems managed refers to the extent to which a patient’s new problem is cared for by PCP vs. referred to another specialist.

^cInvolvement in patient conditions refers to the clinician’s involvement in the care of a patient’s conditions relative to other physicians caring for that patient.

^dScope of services refers to procedures and interventions done at the practice, including sites of care (inpatient, outpatient, home visits, etc.).